Thank you for your question regarding the persistent feeling of looking fat even after undergoing liposuction and maintaining regular exercise. Without photos or more detailed information, it's difficult to determine the exact cause of your concern, but it sounds like you may be dealing with visceral fat. Liposuction effectively removes subcutaneous fat, which is the layer of fat just beneath the skin. This type of fat can be physically removed through the liposuction procedure. However, liposuction does not address visceral fat, which is located deeper in the abdomen around your organs. Visceral fat contributes to an overall appearance of "being fat" and is associated with more significant health risks, including cardiovascular disease and diabetes. Since visceral fat cannot be removed by liposuction, focusing on weight loss through diet and exercise is crucial. Additionally, recent developments in weight management medications could also be beneficial. Drugs like Zepbound (tirzepatide) and Mounjaro have shown promising results in helping reduce weight, including visceral fat, through mechanisms that affect insulin sensitivity, hunger, and satiety. Here are a few steps you can take: Consult with a Healthcare Provider: Discuss your concerns and the possibility of using new weight loss medications with your healthcare provider. They can assess your health needs and determine if these medications are suitable for you. Nutritional Counseling: Consider consulting a dietitian who can help you with a meal plan that targets weight loss and helps reduce visceral fat. Continued Physical Activity: While you exercise regularly, tweaking your exercise regimen with the help of a fitness professional might provide better results in targeting visceral fat. Focus on a mix of cardiovascular exercises, strength training, and potentially high-intensity interval training (HIIT). Regular Monitoring: Keep track of your progress through body composition analysis if available, as this can help distinguish between visceral and subcutaneous fat levels. It's important to address this issue holistically, and while another round of liposuction might help with any remaining subcutaneous fat, it won't be effective against visceral fat. The combined approach of diet, exercise, and possibly medication will likely yield the best results. Sincerely, Dr. Katzen